Risk Factors for Vertebral Deformities in Men: Relationship to Number of Vertebral Deformities

Abstract

Recent epidemiological studies suggest a similar overall prevalence of vertebral deformity in men to that in women, though the influence of increasing age on the prevalence of vertebral deformity is less marked in men. However, most affected men have only a single or two vertebral deformities, which may be unrelated to osteoporosis. The aim of this study was to examine the role of risk factors, previously demonstrated to be associated with vertebral osteoporosis in females, in men with single/dual deformities compared to those with multiple deformities. Age stratified random samples of men aged 50 years and over were recruited from population registers in 30 European centers as part of the European Vertebral Osteoporosis Study (EVOS). Subjects had a lateral spinal radiograph and the presence of vertebral deformity was determined using the McCloskey algorithm. Lifestyle and other risk factor data were obtained from an interviewer-administered questionnaire. In all 6937 men with a mean age of 64.4 (SD ‫؍‬ 8.5) years were studied of whom 738 (10.6%) subjects had one or two deformities, and 109 (1.6%) subjects had three or more deformities. There was a marked increase in the prevalence of multiple vertebral deformities with increasing age, but only a modest effect of age on the prevalence of single deformities. Associations between various risk factors for osteoporosis and vertebral deformity were analyzed separately in men with single/dual vertebral deformity from those with three or more deformities using logistic regression. After adjustment for age, there were statistically significant associations between the following risk factors and multiple deformities: previous hip fracture (odds ratio [OR] 10.5), lack of regular physical activity (OR 2.9), low body mass (OR 2.5), and previous steroid use (OR 2.3). By contrast, there were only weak associations with these same variables in males with single/dual deformities and, apart from poor self-reported general health, all of the 95% confidence intervals spanned unity. There was no difference in the reporting of very heavy levels of physical activity under the age of 50 years between men with single/dual deformities and those with multiple deformities. In conclusion, men with multiple deformities showed a similar pattern of risk factor association to those seen in women with vertebral deformity, in contrast to men with single/dual deformities. (J Bone Miner Res 2000;15:278-283)

Low clinical relevance of a prevalent vertebral fracture in elderly men—the MrOs Sweden study

“…Also from other perspectives, the present results seem to agree with the previous studies, as the prevalence increased by age [16,26,[31][32][33], the majority of men had only one vertebral fracture [1,2,16], and the prevalence was lower than reported in women [1,2,7,8]. Hence, no substantial changes in the pattern or prevalence of vertebral fractures in old men seems evident during the recent decades.…”

High prevalence of vertebral fractures despite normal bone mineral density in patients with long-term controlled acromegaly

“…The prevalence of VFs in acromegalic patients largely exceeded the prevalence in the control population, in all age groups (25). In addition, large European population-based cohort studies also report a much lower prevalence of VFs in both men and women (28)(29)(30)(31)(32), comparable to the findings in the Dutch reference cohort. Our findings, based on the scoring of two independent scorers and confirmed by an experienced radiologist, demonstrate that the prevalence of VFs in acromegalic women, but even more so in acromegalic men, exceeds the reported prevalence of VFs in the general population, including the Dutch population.…”

Osteoporosis and Silent Vertebral Fractures in Nursing Home Resident Elderly Men in Turkey

“…Consistently, we found an osteopenia prevalence of 40.8% and an osteoporosis prevalence of 18.4% in our study. Most studies evaluating osteoporosis in nursing home residents were conducted in females, and an osteoporosis prevalence of 80% e95% was reported in this population (16). In a few studies conducted in men residing in nursing homes, mostly peripheral (particularly calcaneus and forearm) BMD was used, and osteoporosis rate was reported to be 34%e62% (7,23).…”